AB0704 LOW BODY MASS INDEX IN PATIENTS WITH RAYNAUD PHENOMENON IS ASSOCIATED WITH ENLARGED CAPILLARIES AND REDUCTION IN CAPILLARY DENSITY AT NAILFOLD VIDEOCAPILLAROSCOPY
Authors: G. Natalello, L. Verardi, C. Policola, L. Gigante, P. G. Cerasuolo, F. Sciarascia Mugnozza, G. Alonzi, E. De Lorenzis, S. Della Casa, M. A. D’Agostino, S. L. Bosello
Journal: Annals of the Rheumatic Diseases (2022)

Background Increased prevalence of peripheral vascular symptoms like Raynaud’s phenomenon (RP) and acrocianosis is reported in anorexia nervosa (AN) and correlates with a more severe malnutrition. Objectives We aimed to characterize nailfold video capillaroscopy (NVC) abnormalities in patients with RP and BMI&lt;18.5 kg/m2, according to adipokine levels, compared to subjects with RP and normal BMI. Methods We performed NVC in 21 female patients with primary RP with BMI&lt;18.5 kg/m2, in 18 patients with primary RP and normal BMI, and in 18 patients classifiable as VEDOSS (Very Early Diagnosis of Systemic Sclerosis) and normal BMI, using a video-capillaroscope. Fingers two to four were evaluated bilaterally. Mean and minimum capillary density were registered for each patient, as well as maximum diameter and number of enlarged and giant capillaries, number of micro-haemorrhages and micro-thrombosis. We scored the frequency of enlarged capillaries considering the percentage of dilated capillaries out of the total. Demographic and clinical features of all patients were recorded. Results Patients with RP and low BMI presented a great number of elementary alterations on NVC; some of these modifications were typical of the scleroderma pattern. The percentage of enlarged capillaries was more than 33% of the total in 17(81%) patients with RP and low BMI with respect to 9(50%) of patients with RP and normal BMI (p=0.041). Furthermore, the number of megacapillaries was higher in patients with RP and low BMI compared to patients with normal BMI, while the maximum diameter of capillaries was comparable. Eight patients with low BMI presented a picture resembling an early scleroderma pattern (44%). The frequency of micro-thrombosis, micro-hemorrhages and microaneurysms were comparable in the twogroups. Patients with RP and low BMI presented a lower mean capillary and minimum capillary density compared to patients with RP and normal BMI (mean density: 7.4±1.4vs8.2±1.4,p=0.031; minimum density:4.8±1.0vs5.4±1.0,p=0.05). Patients with RP and low BMI presented a comparable frequency of enlarged capillaries, number of megacapillaries when compared with patients with VEDOSS. Leptin and chemerin levels were lower in patients with low BMI with respect to patients with normal BMI (57.5±35.6vs124.2±92.0pg/mL, p&lt;0.001; 46.9±11.9vs58.3±17.2 ng/mL, p=0.017, respectively); adiponectin levels were comparable. Conclusion Patients with low BMI and primary RP presented a great frequency of enlarged capillaries and a reduction of capillary density when compared with patients with normal BMI. The increased number of microvascular abnormalities on NVC in patients with low BMI reminds the NVC findings typical of early scleroderma, supporting the hypothesis of an endothelial dysfunction in such patients Disclosure of Interests None declared